Acute Dystonia by Droperidol during Intravenous Patient-Controlled Analgesia in Children / 대한마취과학회지

Patient-controlled analgesia (PCA) is an important means for postoperative analgesia with parenteral opioids. However, postoperative nausea and vomiting (PONV) remains a major complication with a PCA system. Droperidol is used in PCA to prevent PONV. Extrapyramidal reactions by droperidol are, however, occasionally induced. We describe two cases of severe extrapyramidal hypertonic syndrome with an IV administration of droperidol in PCA in two children, following orthopedic surgery. One patient showed a hypertonic syndrome 20 minutes after receiving droperidol 1.0 mg IV and the symptoms persisted for nearly 12 h without prescription. Another patient revealed an acute rigidity 19 h after the beginning of PCA and was treated with an IM administration of midazolam 2 mg successfully.

The Antiemetic Efficacy of Prophylactic Ondansetron and Droperidol in Epidural Anesthesia / 대한마취과학회지

BACKGROUND: Ondansetron, a 5-HT3 (hydroxytryptamine receptor 3) receptor antagonist, is effective for prevention and treatment of postoperative nausea and vomiting. This study is to evaluate the intraoperative and postoperative efficacy of prophylactic ondansetron and droperidol in preventing nausea and vomiting in cesarean section patients under epidural anesthesia. METHODS: Sixty ASA physical status I-II parturients undergoing elective cesarean section under epidural anesthesia were allocated to 3 groups received intravenous ondansetron 4 mg (Group O), droperidol 1.25 mg (Group D) and normal saline 1 ml (Group N) after delivery of baby. The intra and postoperative incidence and severity of nausea and vomiting were recorded using 4 point scale (0: none, 1 : mild, 2: moderate, 3: severe). RESULTS: There were significantly lower incidence and severity of nausea and vomiting in Group O and Group D than in Group N during intra and postoperative 24 hours (p<0.05). CONCLUSIONS: Prophylactic ondansetron and droperidol had antiemetic effect in cesarean section patients under epidural anesthesia and these effect was observed long after the normal expected duration.

The Comparison of Effectiveness of Ondansetron and Droperidol on Antiemesis / 대한마취과학회지

BACKGROUND: This study was designed to compare the efficacy and safety of ondansetron with droperidol in the prevention of postoperative nausea and vomiting (PONV) using intravenous patient-controlled analgesia (IV-PCA). METHODS: Sixty women were randomly allocated to one of four groups after total abdominal hysterectomy under general anesthesia, droperidol 1 mg (Group 1), 2 mg (Group 2), ondansetron 2 mg (Group 3), 4 mg (Group 4) bolus injection with butorphanol 1 mg and added the same drug to PCA drug (butorphanol 10 mg). The severity of pain, nausea, vomiting and sedation were assessed at 0, 1, 2, 6, 12, 24, 36 and 48hr postoperatively. RESULTS: The occurrence of nausea and vomiting was significantly higher in Group 1, 2 than Group 4. The sedation score and incidence of dizziness were significantly higher in Group 1, 2 than Group 3, 4. CONCLUSIONS: The addition of ondansetron to PCA drug is more effective and safe in the prevention of postoperative nausea and vomiting and has less sedation and dizziness effect than droperidol. But, droperidol has a cost-saving effect.